Details of TEST BANK Ebersole and Hess’ Gerontological Nursing & Healthy Aging 5th Edition TouhyChapter 01: Introduction to Healthy Aging MULTIPLE
... [Show More] CHOICE
1. A man is terminally ill with end-stage prostate cancer. Which is the best statement about this man’s wellness? a. Wellness can only be achieved with aggressive medical interventions. b. Wellness is not a real option for this client because he is terminally ill. c. Wellness is defined as the absence of disease. d. Nursing interventions can help empower a client to achieve a higher level of wellness.
ANS: D Nursing interventions can help empower a client to achieve a higher level of wellness; a nurse can foster wellness in his or her clients. Wellness is defined by the individual and is multidimensional. It is not just the absence of disease. A wellness perspective is based on the belief that every person has an optimal level of health independent of his or her situation or functional level. Even in the presence of chronic illness or while dying, a movement toward wellness is possible if emphasis of care is placed on the promotion of well-being in a supportive environment.
PTS: 1 DIF: Apply REF: p. 7 TOP: Nursing Process: Diagnosis MSC: Health Promotion and Maintenance
2. In differentiating between health and wellness in health care, which of the following statements is true?
a. Health is a broad term encompassing attitudes and behaviors. b. The concept of illness prevention was never considered by previous generations. c. Wellness and self-actualization develop through learning and growth. d. Wellness is impossible when one’s health is compromised.
ANS: A Health is a broad term that encompasses attitudes and behaviors; holistically, health includes wellness, which involves one’s whole being. The concept of illness prevention was never considered by previous generations; throughout history, basic self-care requirements have been recognized. Wellness and self-actualization develop through learning and growth—as basic needs are met, higher level needs can be satisfied in turn, with ever-deepening richness to life. Wellness is possible when one’s health is compromised—even with chronic illness, with multiple disabilities, or in dying, movement toward a higher level of wellness is possible.
PTS: 1 DIF: Understand MSC: Health Promotion and Maintenance REF: p. 7 TOP: Nursing Process: Evaluation 1 | P a g e3. Which racial or ethnic group has the highest life expectancy in the United States? a. Native
Americans
b. African Americans
c. Hispanic Americans
d. Asian and Pacific Island Americans
Chapter 02: Cross-Cultural Caring and Aging
MULTIPLE CHOICE
1. Which of the following is a true statement about differing health belief systems?
a. Personalistic or magicoreligious beliefs have been superseded in Western minds by
biomedical principles.
b. In most cultures, older adults are likely to treat themselves using traditional
methods before turning to biomedical professionals.
c. Ayurvedic medicine is another name for traditional Chinese medicine.
d. The belief that health depends on maintaining a balance among opposite qualities is
characteristic of a magicoreligious belief system.
ANS: B
Older adults in most cultures usually have had experience with traditional methods
that have worked as well as expected. After these treatments fail, older adults turn to
the formal health care system. Even in the United States, it is common for older adults
to pray for cures or wonder what they did to incur an illness as punishment. The
Ayurvedic system is a naturalistic health belief system practiced in India and in some
neighboring countries. This belief is characteristic of a holistic or naturalistic approach.
PTS: 1 DIF: Understand REF: p. 16-17 TOP: Nursing Process: Assessment MSC:
Health Promotion and Maintenance
2. Which of the following considerations is most likely to be true when working with an
interpreter?
a. An interpreter is never needed if the nurse speaks the same language as the patient.
b. When working with interpreters, the nurse can use technical terms or metaphors.
c. A patient’s young granddaughter who speaks fluent English would make the best
interpreter because she is familiar with and loves the patient.
d. The nurse should face the patient rather than the interpreter.
ANS: D
The nurse should face the patient rather than the interpreter is a true statement; the
intent is to converse with the patient, not with a third party about the patient. Many
reasons may prevent the patient from speaking directly to a nurse. Technical terms and
2 | P a g emetaphors may be difficult or impossible to translate. Cultural restrictions may prevent
some topics from being spoken of to a grandparent or child.
PTS: 1
DIF: Understand
REF: p. 18-19
TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment
3. An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg
and refuses to remain in the bed. Which intervention should the nurse use to promote
and maintain his health?
a. Have the health care provider speak to him.
b. Use principles of the holistic health system.
c. Ask about his perceptions and treatment ideas.
d. Consult with a practitioner of Chinese medicine.
ANS: C
Using the LEARN model (listen with sympathy to the patient’s perception of the
problem, explain your perception of the problem, acknowledge the differences and
similarities, recommend treatment, and negotiate agreement), the nurse gathers
information from the patient about cultural beliefs concerning health care and avoids
stereotyping the patient. In the assessment, the nurse determines what the patient
believes about caregiving, decision making, treatment, and other pertinent health-
related information. Speaking with the health care provider is premature until the
assessment is complete. Unless he accepts the beliefs, principles of the holistic health
system can be potentially unsuitable and insulting for this patient. Unless he accepts
the treatments, consulting with a practitioner of Chinese medicine can also be
unsuitable and insulting for this patient.
PTS: 1
DIF: Apply
REF: p. 18
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
4. Which action should the nurse take when addressing older adults?
a. Speak in an exaggerated pitch.
b. Use a lower quality of speech.
c. Use endearing terms such as “honey.”
d. Speak clearly.
ANS: D
Some health professionals demonstrate ageism, in part because providers tend to see
many frail, older persons and fewer of those who are healthy and active. Providers
should not assume that all older adults are hearing or mentally impaired. The most
appropriate action when addressing an older adult would be to speak clearly. Examples
of unintentional ageism in language are an exaggerated pitch, a demeaning emotional
tone, and a lower quality of speech.
PTS: 1
DIF: Apply
REF: p. 15
3 | P a g eTOP: Nursing Process: Assessment
MSC: Health Promotion and Maintenance
5. The nurse prepares an older woman, who is Polish, for discharge through an interpreter
and notes that she becomes tense during the instructions about elimination. Which
intervention should the nurse implement?
a. Move on to the discussion about medication.
b. Ask the older woman how she feels about this topic.
c. Instruct the interpreter to repeat the instructions.
d. Have the older woman repeat the instructions for clarity.
ANS: B
When working with an interpreter, the nurse closely watches the older adult for
nonverbal communication and emotion regarding a specific topic and therefore
validates the assessment about the older adult’s tension before proceeding. Because
the nurse notices her tension, the nurse temporarily suspends the preparation to
validate her assessment. If the nurse proceeds and the older adult is uncomfortable
discussing elimination, then important instructions can be missed, leading to adverse
effects for the older adult. Repeating the instructions can aggravate the older adult’s
discomfort. Instructing the older adult to repeat the nurse’s instruction ignores her
needs.
PTS: 1
DIF: Apply
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
6. The nurse plans care for an older African American man who is from Jamaica and
resides in New York City. Which should the nurse include in planning care? a.
Attribute his illness to breaking a voodoo.
b. Help him improve social relationships.
c. Maintain blood pressure below 120/70 mm Hg.
d. Review the principles of the magicoreligious system.
ANS: C
Because African Americans tend to be at risk for cardiovascular disease and
hypertension, the nurse plans to maintain the patient’s blood pressure at or below the
current recommendation by the American Heart Association. The nurse can be
incorrectly assuming that he practices and believes in the magicoreligious system. The
nurse should assess his spiritual beliefs and determine how much they influence his
attitudes toward Western health care. The magicoreligious system maintains social
relationships in good condition to prevent illness; however, if the older adult does not
follow this cultural practice, then this goal can be unsuitable. The older adult may not
believe in this system; therefore, the information can be irrelevant.
PTS: 1
DIF: Apply
MSC: Safe, Effective Care Environment
REF: p. 18-19
TOP: Nursing Process: Planning
REF: p. 18-19
4 | P a g e7. Which health belief system uses treatments to repair a body part?
a. Holistic
b. Biomedical
c. Personalistic
d. Magicoreligious
ANS: B
Because dysfunction or a structural abnormality is thought to cause disease, the
biomedical system believes in repairing the structural abnormality. The holistic system
holds that health is attained through balance. The personalistic system uses treatments
such as meditation, fasting, and praying. The magicoreligious system is the same as the
personalistic system.
PTS: 1
DIF: Understand
TOP: Nursing Process: Assessment
REF: p. 17
MSC: Safe, Effective Care Environment
8. A nurse is caring for a culturally diverse patient who has missed follow-up appointments
with the primary care provider three times over the past year. The patient has a chronic
illness that requires periodic monitoring of blood test values. The patient tells the nurse:
“You don’t understand—in my culture, we don’t do things like that. I cannot be troubled
with worrying about appointments in the future; I deal with each day as it comes.” The
nurse understands which of the following about the patient’s culture? a. The culture does
not value Western medicine.
b. The culture has a different orientation to time than Western medicine.
c. The culture is an interdependent culture.
d. The culture does not believe in preventative care.
ANS: B
Time orientation is a culturally constructed factor. Westernized medical care is future
oriented. Conflicts between future oriented Westernized medical care and those with a
present or past time orientation may arise. Patients are likely to be labeled as
noncompliant for failing to keep appointments.
PTS: 1
DIF: Understand
MSC: Safe, Effective Care Environment
9. A paper on culture and illness would be likely to include the statement that
a. culture is the same as ethnicity.
b. ethnic groups always share common geographic origin and religion.
c. ethnicity involves recognized traditions, symbols, and literature.
d. most members of an ethnic group exhibit identical cultural traits.
ANS: C
REF: p. 15-17
TOP: Nursing Process: Planning
5 | P a g eEthnicity is a complex phenomenon that includes traditions, symbols, literature,
folklore, food preferences, and dress. It is a shared identity. Ethnicity is more than just
culture. It is social differentiation based on culture. Even within ethnic groups, there is
considerable diversity.
PTS: 1
DIF: Remember
MSC: Psychosocial Integrity
10. A home care nurse is caring for an older patient from a different culture who is
bedbound and high risk for development of a pressure ulcer. The nurse discusses the
plan of care with the patient’s daughter, emphasizing the importance of turning every 2
hours, and posts a turning clock on the wall. When the nurse returns later in the week,
the turning clock has been removed, and the patient’s daughter reports that she turns
her mother occasionally. She states, “I am taking very good care of my mother. You just
don’t understand—our ways do not involve doing things on schedules.” The best
response by the nurse is:
a. “You must follow my guidelines and turn her every 2 hours, or I will not be able to
take care of her.”
b. “I understand that you value your culture, but culture cannot stop you from
providing good care to your mother.”
c. ‘I understand that you care very much for your mother. Perhaps caring for her is
too much for you.”
d. “How can we best work together to provide the best care for your mother?”
ANS: D
In providing cross-cultural care, it is important that the nurse work with the patient
and family and listen carefully and find a way to include the values and beliefs of the
patient in the plan of care.
PTS: 1
DIF: Analyze
TOP: Communication and Documentation
REF: p. 15
MSC: Psychosocial Integrity
11. An older patient learns that she has metastatic cancer. The patient states: “I must have
angered God.” This is an example of which type of belief? a. Biomedical
b. Magicoreligious
c. Naturalistic
d. Ayurvedic
ANS: B
Magicoreligious beliefs view illness as caused by actions of a higher authority.
Biomedical beliefs view disease as a result of abnormalities in structure and function
and disease caused by intrusion of pathogens into the body. Naturalistic beliefs are
based on the concepts of balance; health is seen as a sign of balance. Ayurvedic beliefs
REF: p. 12
TOP: Teaching and Learning
6 | P a g eare of the oldest known paradigm in the naturalistic system; illness is seen as an
imbalance.
PTS: 1
DIF: Remember
TOP: Communication and Documentation
REF: p. 17
MSC: Psychosocial Integrity
12. The term health disparity is defined as
a. the systematic elimination of the culture of another resulting in decreased wellness.
b. differences in health outcomes among groups.
c. the difference between an expected incidence and prevalence and that which
actually occurs in a comparison population group.
d. the existence of more than one group with differing values and perspective.
ANS: B
Health disparities are defined as differences in health outcomes among groups. Cultural
destructiveness is defined as the systematic elimination of the culture of another.
Health inequities are defined as the difference between an expected incidence and
prevalence and that which actually occurs in a comparison population group. Cultural
diversity is defined as the existence of more than one group with differing values and
perspective.
PTS: 1
DIF: Remember
MSC: Psychosocial Integrity
MULTIPLE RESPONSE
1. The nurse is assessing an older adult from a culture different than the nurse’s by asking
questions from the explanatory model for culturally sensitive assessment. Which
question(s) should the nurse ask to follow this model? (Select all that apply.) a. How can
we negotiate to solve the problem?
b. What treatment can improve your condition?
c. Should we try my plan first to see if it helps?
d. Can we discuss differences in our plans now?
e. How long have you experienced the problem?
f. Who, other than me, can make you feel better?
ANS: B, E, F
Asking about potential therapies is a question from the explanatory model and asks
what the individual believes will help clear up the problem. The nurse asks about the
duration of the problem as a part of applying the explanatory model. The nurse asks
about other disciplines that the individual believes can be therapeutic. This question is
based on the LEARN model.
PTS: 1
DIF: Apply
REF: p. 14
REF: p. 13
TOP: Teaching and Learning
7 | P a g eTOP: Nursing Process: Assessment
MSC:
Health
Maintenance
2. A nurse caring for older adults must be aware of which consequences of ageism in
language?
(Select all that apply.)
a. Reduced sense of self
b. Poor nutritional intake
c. Lowered sense of self-competence
d. Decreased memory performance
ANS: A, C, D
Some health professionals demonstrate ageism, in part because providers tend to see
many frail, older persons and fewer of those who are healthy and active. Consequences
of ageism have been identified as a reduced sense of self, lowered self-esteem, lowered
sense of self-competence, and decreased memory performance. Poor nutritional intake
has not been identified as a consequence.
PTS: 1
DIF: Apply
TOP: Nursing Process: Assessment
REF: p. 15
MSC: Health Promotion and Maintenance
3. Which factor(s) is/are associated with the provision of culturally competent care? (Select
all that apply.)
a. Cultural awareness
b. Cultural knowledge
c. Cultural skills
d. Cultural connections
e. Knowledge of specific details of traditions and practices of all the different cultures
ANS: A, B
As nurses move toward cultural competence, they increase their cultural awareness,
knowledge, and skills. Cultural competence means having the skills to put cultural
knowledge to use in assessment, communication, negotiation, and intervention.
Cultural connections have not been identified as a factor.
PTS: 1
DIF: Apply
TOP: Nursing Process: Assessment
REF: p. 15
MSC: Health Promotion and Maintenance
4. A nurse completes a cultural assessment of an older adult who is being admitted to an
assisted living facility. Reasons for completing a cultural assessment include (Select all
that apply.) a. culture guides decision making about health, illness, and preventive care.
b. culture provides direction for individuals on how to interact during health care
encounters.
c. culture impacts attitudes toward aging.
d. all members of a culture react in the same way in similar situations.
8 | P a g e
Promotion
ande. knowledge of culture eliminates health care disparities.
ANS: A, B, C
Although knowledge of culture has the potential to optimize care, not all individuals
will respond in the same way to a specific situation. Knowledge of an individual’s
culture will not eliminate health care disparities.
PTS: 1
DIF: Understand
MSC: Psychosocial Integrity
5. A nurse in the ambulatory care setting is preparing to do an interview with a non–
English-speaking client. The nurse secures an interpreter. To have the most effective
interview, the nurse should do which of the following? (Select all that apply.) a. Look and
speak to the interpreter.
b. Use technical terminology to ensure accuracy.
c. Allow more time for the interview.
d. Watch the client’s nonverbal communication.
e. Through the interpreter, check whether the client understands the communication.
ANS: C, D, E
For the most effective interview the nurse should look and speak directly to the client;
avoid the use of jargon and technical terminology; observe the client’s nonverbal
communications; and clarify understanding by asking the client to state in his or her
own words what he or she understood, facilitated by the interpreter. The interview will
naturally take longer.
PTS: 1
DIF: Remember
TOP: Communication and Documentation
REF: p. 18-19
MSC: Psychosocial Integrity
REF: p. 15-16
TOP: Teaching and Learning
ANS: C
As shown in Figure 1.4, Hispanic men and women have the highest life expectancy of
all. In 2011, for those of Hispanic origin of any race, the overall life expectancy at 65
years of age was 20.7 more years in 2011 (19.1 years for men and 21.8 years for
women).
9 | P a g ePTS: 1
DIF: Understand
TOP: Nursing Process: Assessment
REF: p. 6
MSC: Safe, Effective Care Environment
4. Historical influences that have shaped the lives of the majority of the in-between cohort in
the United States today include which of the following? a. Influenza epidemic of 1918
b. World War I
c. Child rearing in the Depression
d. World War II
ANS: D
Those who are in the in-between cohort in 2016 were born between 1915 and 1945.
The men were likely to have fought in World War II. The last of the Holocaust survivors
are in this group. A person who survived the influenza epidemic would be at least 98
years old in 2016 and therefore would be considered old-old or a centenarian. Most of
those who are of the in-between cohort had not reached childbearing age by the end of
the Depression. Individuals in the in-between cohort would not have been old enough
to fight in World War II.
PTS: 1
DIF: Understand
TOP: Nursing Process: Assessment
REF: p. 5
MSC: Safe, Effective Care Environment
5. According to researchers, which characteristic do most centenarians share?a. Female b.
Hispanic
c. Living in rural areas
d. Located in the Midwestern states
ANS: A
Based on the U.S. census report of 2010, centenarians were overwhelmingly white,
female, and living in the urban areas of the Southern states.
PTS: 1
DIF: Remember
TOP: Nursing Process: Assessment
REF: p. 5
MSC: Safe, Effective Care Environment
6. Which nursing intervention is a holistic approach to an older adult?
a. Performs glucose testing during the weekly worship service
b. Wheels ambulatory adults to exercise when running late
c. Assigns female nurses to older women who are Islamic
d. Allows older adults in a nursing home to eat meals alone
ANS: C
10 | P a g eThe nurse uses a holistic approach to the care of an older female adult who is Islamic
because the woman and her family are more likely to be willing participants in a
therapeutic regimen that respects a tenet of their culture. Interrupting an older adult’s
worship with glucose testing can be interpreted as a lack of respect for spiritual needs.
The nurse can provide for and respect the physical and spiritual aspects of the older
adult’s life by testing for glucose before the service begins. In transporting ambulatory
adults to the exercise program in wheelchairs to save time, the nurse disregards the
need for self-esteem and exercise, both important aspects of physical well-being.
Ambulatory adults can walk with assistance, if needed, to exercise programs and can
benefit from the additional activity and independence. The nurse can be tempted to
allow an older adult to eat meals alone in his or her room if this will motivate the
person to eat or if the older adult has dysphasia and is embarrassed. However,
although focusing on physical needs, the nurse ignores psychosocial and other aspects
of health and well-being.
PTS: 1
DIF: Understand
MSC: Health Promotion and Maintenance
7. An older man who resides in a nursing home has a total cholesterol level of 245
mg/dL. Which nursing intervention is most likely to assist this man in achieving his
highest level of wellness?
a. Instruct him about increasing dietary fiber.
b. Ask the health care provider for a low-fat diet.
c. Schedule a consultation for him with the dietitian.
d. Review a menu with him to choose suitable foods.
ANS: D
The nurse collaborates with the older adult to choose suitable foods, which is likely to
be an effective nursing intervention to help an older adult with hyperlipidemia achieve
optimal
health and well-being; it gives him some control over the regimen and thus engages
him in the process of lowering serum cholesterol. Informing the older man about
dietary fiber offers no control to him because he is not part of the decision. Nursing
interventions developed with the older adult’s collaboration are most likely to help the
older adult achieve health and wellness. Collaborating with the health care provider for
a low-fat diet is a reasonable approach to help this man with hyperlipidemia to achieve
health and wellness. However, he is more likely to have motivation and enthusiasm for
a therapeutic regimen over which he has had some control. Scheduling a consultation
with a dietitian is a reasonable approach to an older adult with hyperlipidemia and is a
part of a multifaceted approach to optimizing his health. However, the older adult is
more likely to engage in a regimen over which he has input.
PTS: 1
DIF: Analyze
REF: p. 7
TOP: Nursing Process: Planning
REF: p. 7
TOP: Nursing Process: Evaluation
11 | P a g eMSC: Health Promotion and Maintenance
8. Which approach requires the nurse to integrate and balance all aspects of an individual’s
life into the plan of care? a. Holistic nursing
b. Healthy People 2020
c. Maslow’s hierarchy of human needs
d. Orem’s self-care requirements
ANS: A
Holistic nursing integrates all aspects of an individual’s life into the plan of care by
balancing an individual’s internal and external environment with psychosocial,
spiritual, cultural, and physical processes. Healthy People 2020, an updated document
from 2000 that outlines the goals for achieving health in this country, is a mandate for
health care professionals to follow with 467 objectives in 28 focus areas. Maslow’s
hierarchy of human needs provides a basis for understanding individuals in context
and for ranking nursing assessments, diagnoses, goals, and interventions in order of
importance. Dorothea Orem’s self-care requirements lists human needs, including the
need for air, fluids, nutrition, hygiene, elimination, activity, comfort, relief from
suffering, and skin integrity. The nurse helps individuals meet these needs to achieve
optimal health and wellness.
PTS: 1
DIF: Remember
TOP: Nursing Process: Assessment
REF: p. 7
MSC: Safe, Effective Care Environment
9. The nurse plans activities for older women born between 1920 and 1930 and who
reside in an assisted-living facility. Which is the best intervention for the nurse to
implement? a. Have them bake cookies twice a week.
b. Conduct interviews for specific interests.
c. Arrange dog and cat visits from volunteers.
d. Take them to the library for guest speakers.
ANS: B
The nurse conducts individual interviews with the women to determine their interests
and to avoid generalizing; as people live longer, they become more and more unique.
Because most of these women are in their 80s and 90s were born between 1920 and
1930 and have generally spent their lives as homemakers, the nurse presumes to know
what activities they will enjoy.
The nurse avoids arranging group activities until individual interests are determined. In
addition, the nurse must assess for allergies and individual fears of animals before
exposing an
older adult to a pet visit. Unless it is organized on a voluntary basis, the nurse avoids
arranging visits by guest speakers. In addition, the nurse will assess each older woman
12 | P a g ebefore an outside visit to avoid embarrassing events, including incontinence and
hearing and vision problems.
PTS: 1
DIF: Analyze
REF: p. 5
TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment
10. Which of the following issues in the care of older adults are identified in Healthy People
2020?
a. Delineating nursing staffing levels in long term care
b. Eradicating pressure ulcers in all care settings
c. Identifying minimum levels of training for people who care for older adults
d. Instituting mandatory training in identification of elder abuse for all caregivers of
older adults
ANS: C
Identifying minimum training levels for people who care for older adults is one of the
issues identified in Healthy People 2020. The rest of the issues are not discussed in
Healthy People 2020.
PTS: 1
DIF: Remember
MSC: Health Promotion and Maintenance
Chapter 03: Biological Theories of Aging and Age-Related Physical Changes
MULTIPLE CHOICE
1. Decreased functioning of which physical structure is likely to result in decreased
metabolism in older adults? a. Kidney
b. Thyroid gland
c. Brain
d. Skeleton
ANS: B
Secretion of thyroid hormones tends to decrease with age, resulting in a greater
likelihood of a slower metabolism, hypothyroidism, and thinning hair and nails.
Decreased kidney function leads to decreased glomerular filtration rate and the ability
of the kidneys to concentrate urine and clear waste. Decreasing brain function tends to
result in decreased cognitive functioning. Osteoclastic activity tends to decrease with
age, increasing the risk for osteopenia and osteoporosis.
PTS: 1
DIF: Understand
TOP: Nursing Process: Assessment
REF: p. 32
MSC: Physiological Integrity
2. An older female patient is reading a large-print magazine and states that reading is
difficult for
REF: p. 8
TOP: Teaching and Learning
13 | P a g eher in the evening. Which intervention should the nurse implement?a. Put a high-intensity
lamp at the head of her bed.
b. Explain to her that the gray-yellow ring around her cornea, arcus senilis, is
interfering with visual acuity.
c. Put more powerful tubes in the fluorescent room lights.
d. Examine her retinas for signs of damage.
ANS: A
The pupils become gradually smaller with age; therefore, the eye requires three times
as much light. A high-intensity light on the object of interest is more effective than
increasing the overall room illumination. The arcus senilis does not affect vision. The
patient is describing a gradual overall change, not the more localized or sudden effects
of macular degeneration or retinal detachment.
PTS: 1
DIF: Apply
REF: p. 35
TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment
3. Aging ordinarily leads to decreases in which of the following?
a. Creatinine clearance and insulin secretion
b. Blood carbon dioxide and saliva production
c. Left ventricle-wall thickness and skin healing time
d. Serum triiodothyronine (T3) and gastric pepsin
ANS: D
Serum T3 and pepsin secretion both decrease with aging. Creatinine clearance declines,
but insulin secretion normally remains stable. Saliva production decreases, but blood
carbon dioxide normally remains unchanged. Left ventricle wall thickness and skin
healing time both increase with aging.
PTS: 1
DIF: Understand
TOP: Nursing Process: Assessment
REF: p. 30-31
MSC: Physiological Integrity
4. Which change in the skin is abnormal in an older person?
a. Thinner and more fragile skin
b. Red, swollen 3-day-old wound
c. Greater number of freckles
d. Loss of hair on the extremities
ANS: B
Although the skin of an older person may require 48 to 72 hours to mount an initial
inflammatory response to a wound, increasing redness after that time, particularly with
purulent discharge, is a sign of infection. This change is normal as ridges in the skin are
lost. Melanin distribution becomes more uneven with age. Hair is commonly lost from
14 | P a g ethe legs and other areas of older adults. Hair loss from the legs is not a sign of peripheral vascular disease.
PTS: 1 DIF: Understand TOP: Nursing Process: Assessment REF: p. 27 MSC: Physiological Integrity
5. The nurse designs a group exercise program at a senior center. Which room should the nurse choose for the program? a. Room with a beautiful hardwood floor tastefully appointed with throw rugs b. Spacious room with no windows but with fluorescent lighting and a natural stone floor
c. Room with a hardwood floor and large windows overlooking a garden area d. End room with a linoleum floor and a fan for ventilation to compensate for the room’s broken air conditioner
ANS: C The hardwood floor provides an even surface. If the daylight from the large windows causes a glare problem, then curtains may be used. Throw rugs can slide underfoot and can lead to a fall, particularly when the sense of balance has declined with age. Fluorescent lighting can lead to a glare problem, and the irregularities of the natural stone floor can lead to a fall. The linoleum floor also presents a glare problem, and overheating is a risk in older persons who have a reduced sweat-gland response to heat.
PTS: 1 DIF: Apply TOP: Nursing Process: Assessment REF: p. 35 MSC: Physiological Integrity
6. The latest trends in medicine encourage health care providers to prescribe nutrient-dense foods and exercise to prevent or delay the shortening of telomeres. On which biological theory of aging are these practices based? a. Genetic research b. Caloric restriction c. Oxidative stress d. Cross-link
ANS: A Genetic researchers have found that telomeres shorten with each cellular reproduction and continue to do so until the cell dies. Selected animal studies since the 1930s conclude that calorie restrictions of 30% can lead to a longer life expectancy, slower metabolism, lower body temperature, and delay of age-related disorders. The pacemaker theory, which is also known as the neuroendocrine control theory, holds that critical functions of selected endocrine glands slow and can halt with age. The cross-link theory suggests that aging is a result of the stiffening of proteins caused by cross-linking, leading to stiffer joints, rougher skin, and decreased cellular elasticity.
PTS: 1 DIF: Understand REF: p. 22-26 15 | P a g e [Show Less]